U.S. Surgeon General visits Montana to say, 'keep your guard up'

U.S. Surgeon General Vice Adm. Jerome Adams said Thursday that Montanans need to continue taking the pandemic seriously in preparation for the vaccine rollout.

“Just because the cavalry is coming, that doesn’t mean you just open the gates, lie down and let the enemy attack you,” Adams said while at a press conference in Helena with Gov. Steve Bullock. “You have to keep your guard up, you need to keep defending the fort until the cavalry arrives, and we need you to do your part.”

Adams said it is tempting to lower ones guard, but now, more than ever, people need to be careful in what looks like the home stretch of this global pandemic.

“Running a marathon is incredibly hard, and the hardest part is the last couple of miles,” he said. “But you get the strength to keep going when you know the finish line is just around the corner. And I want Montanans to know that the finish line is just around the corner.”

Adams said he’s highly confident in the Pfizer and Moderna vaccines that he said appear to be some of the most effective ever produced, but until they become widely available people must continue maintaining hand hygiene, social distancing and wearing masks.

He said he understands the aversion to following orders and respects Montanans’ individualism, but ultimately it is in everyone’s interest to wear masks.

“I know Montanans are proud to be independent, you make up your own minds,” he said. “I grew up on a farm, I grew up in the country, I know what it’s like to have no one but yourself to depend on, and I know what it’s like to not want to have others telling you what to do. But, here’s what I’ll say to you: masks work.”

Adams said while the virus is small, the droplets that carry it are much larger and can be prevented from spreading through use of cloth masks.

He said the data shows that communities that wear more masks have less spread and have been able to keep businesses and schools open far more consistently.

He said Europe had it’s third surge a few weeks before the U.S. and it was only five weeks long because they aggressively wore masks and socially distanced, while the U.S. is nine weeks into its own surge.

Adams said President Donald Trump, Vice-President Mike Pence and the federal COVID-19 Task Force Adams is part of wanted him to come to Montana and point out what a pivotal time this is for the state.

“We have seen record cases for nine weeks in a row, we’re seeing those turn into record hospitalizations, and yesterday we had our deadliest day ever due to this virus.” he said. “It is a precarious time and we should all be concerned. … But Montana has proven that these mitigation efforts can work.”

He said the scientific community’s understanding of COVID-19 continues to evolve every day, but they now know more than ever and the data is clear that these measures work.

Despite this evidence, Adams said, he still hears myths about mask wearing and addressed one he’s heard most frequently, that masks make people rebreathe CO2, causing health problems.

“I hate to even repeat some of these myths but that’s a very common one,” he said. “I am an anesthesiologist, I have worn a mask most hours of the day for most of my adult life. If rebreathing carbon-dioxide through a mask was a danger you would have millions of brain-damaged surgeons and nurses all over the state. It’s just factually incorrect.”

Adams said one of his regrets during the pandemic is not sufficiently explaining why recommendations change over time and why that is evidence of the scientific community’s integrity, not weakness.

Science’s understanding naturally evolves based on observation and data analysis, and as more data comes in, understanding improves, and guidelines change, he said.

Adams said in the early months of the pandemic, no one knew just how effectively the virus could spread through asymptomatic individuals, something respiratory disease are usually not good at.

This drove the initial recommendation to not wear masks early in the year. But once the data came in and the scientific community understood more they changed their recommendation.

Adams said the consequences of not taking the pandemic seriously are clear, especially with so many hospitals in Montana at 100 percent capacity already.

“Do you know what that means?” he asked. “It means even if you are not scared of the virus, you might not be able to get a hospital bed if you have a heart attack, if you’re in labor, if you get into a car accident, because the hospital might not have a bed for you.”

He said this surge is more dangerous than the first and second because they had centers of greatest spread, New York and the Southwest respectively, and as such resources could be pooled and moved around.

However, this wave is much more even across the country, and much more intense, and pooling resources the way they were earlier is no longer an option.

Virus is hitting Indian Country hard

Adams said one thing he wanted to highlight during his time in Montana was just how badly the pandemic is hurting Native American communities.

“This pandemic has hit us all hard, but it’s hitting some communities particularly hard,” he said.

He said while Native Americans make up about 7 percent of Montana’s population they account for almost 20 percent of the cases and almost a third of the deaths.

“This is unacceptable, and it shows how this virus has preyed on people not just with pre-existing medical conditions, but pre-existing social conditions that conspire to reduce our resilience opportunity and our health,” he said.

Vaccines being approved

Adams said people need to understand that vaccines in the modern day are very safe, and these ones have been researched especially closely despite the short timeframe of their development.

He said the average vaccine trial has 5,000 people in it, these have 30,000 to 60,000 people, and they now have more data behind them than any other vaccine in history.

He said he wanted people to understand that the development and approval of these vaccines hasn’t cut any corners outside of typical bureaucratic delay.

Adams said he’s confident enough in the vaccine that he’ll happily take it on national television if it gets other people on board.

He said despite some reports of allergic reactions to vaccines in the U.K. people should have confidence the vaccine is not dangerous and reactions will be monitored closely on a large scale by the government and on the ground level by those administering the vaccine.

He said facilities administering them will be prepared for reactions and respond appropriately.

Adams said when a large number of people are exposed to a new substance it is inevitable that some will be allergic to it, that it’s not unexpected, and something that they are prepared for.

He said almost no one truly sees the full benefit of modern vaccines because almost no one knows someone who’s died because of measles or small pox, but he thinks it will be different now.

However, he said, there are important things people need to know about the vaccine.

He said getting it doesn’t mean you can’t get infected, but that it’s far less likely to cause someone harm and makes it more difficult to spread.

Adams said it is likely that mitigation efforts will need to continue through the first half of next year, but spread will decrease immensely and more and more businesses will be able to operate without serious concern about spread.

He said he thinks it’s unlikely that businesses and hospitals will require staff to get the vaccine and but it will ultimately be up to them and people should get it regardless.

People need to do their part

Normalcy will come, Adams said, but only if everyone does their part.

He thanked the people of Montana for staying strong despite the gloominess these months have brought.

“I know that we’re always talking about, and you’re always hearing about, people that aren’t doing the things that we know will slow the spread of the virus,” he said. “But, here are the facts: more people than ever are wearing face coverings, more people than ever are sacrificing and keeping their gatherings small. But, the fact also is that this virus is incredibly unforgiving, it’s incredibly contagious, and we all need to do our part to slow the spread and save lives.”

Adams also advised Montanans to get their flu vaccine ASAP, and that the state can’t afford more hospitalizations during the pandemic.

How the vaccine will roll out in Montana

Bullock provided more information about the vaccine’s roll out.

He said the first shipments of the Pfizer vaccine will begin, going to front-line health care workers, as early as next week as soon as an emergency use authorization is granted.

He said this first round will see 9,750 doses come into the state and will be given to Montana’s 10 largest hospitals serving its seven largest communities.

“First in line to receive these doses will be Montana’s health care workers who have worked tirelessly for nine months to care for the people of this state under very trying circumstances,” he said.

Bullock said subsequent rounds including the Moderna vaccine, presumably arriving one week later than Pfizer’s, will target more health care workers as well as health care workers and residents at skilled nursing facilities.

Bullock spokesperson Marissa Perry said Monday that critical care hospitals like Liberty Medical Center in Chester and Big Sandy Medical Center and Northern Montana Hospital are planned to be included in the second round of distribution to vaccinate their health care workers.

Bullock said Thursday that by prioritizing those on the front line, the state will help ensure that hospitals and staff can continue serving patients without risk of labor shortage due to workers needing to quarantine, isolate or worse.

He said after long, dark, challenging months in Montana, this news is encouraging.

Bullock said the state’s recent decline in the rate of new positive cases and hospitalizations is good to see and the Nov. 20 restrictions and further encouragement of mask wearing and social distancing seem to be working.

He said new case counts in Yellowstone county have decreased by 36 percent, Gallatin 38 percent, and the state’s positivity rate has dropped from 20 percent high in mid-November to 14 percent now.

“Looking at the data it appears that Montanans are stepping up and taking the steps needed to mitigate the spread of this virus,” Bullock said.

He said while the restrictions have made a difference, Montanans can continue to save lives by taking the pandemic seriously.

“We can’t let our guard down, not now and not in the coming months,” he said. “... We are at a crossroads in how we choose to manage this virus.”

Bullock said social distancing, avoiding gatherings, and practicing hand hygiene will save lives and keep hospitals from being overrun.

“We can show our doctors and nurses and health care providers that we truly appreciate that they haven’t given up the fight and neither should we,” he said. “… That choice is in our hands.”